How To Do Technology Better in Healthcare
‘Our healthcare system is broken’ is an ubiquitous phrase in digital health startups.
Tech entrepreneurs didn’t coin it, but we say it loudly and frequently — as do politicians, hospital systems, doctors, and Amazon. We’re all in agreement there’s a problem, and many of us are working hard to find the solution. This is where the health innovation economy shines: we recruit smart people, convince well-funded investors, and craft strategic partners; then we point them all at a well defined mission to change things for the better. Digital health startups live up to these ideals well. I’m continually blown away by the time, intelligence, and doggedness of digital health entrepreneurs working to build technology for and innovation in the system. The problem, all too often, is that we miss the broader goals of healthcare: taking care of people. Healthcare, the act of taking care of one another, is an innately human endeavor — the technology we build should be the same, but again and again, it just isn’t.
Before the pandemic, I was a New York startup Chief Technology Officer in the travel industry. In 2020, I moved my meetings to zoom, watched my company lose 100% of its revenue, and moved in with my parents. My day job became all about keeping a company alive. Unfortunately, that’s also when I took on my second job: as a caregiver to my Dad, recently diagnosed with ALS. Between calls with airlines and hotels, I talked with nurses and home health aides. Before and after work, I measured medicine, changed bedding, and spent time with my Dad. As my family’s resident IT support desk, my normal duty of fixing the printer evolved into anxiously fixing the CPAP machine when it continually and disastrously stopped working. It was this experience that showed me just how healthcare technology — purpose-built to help patients — can introduce more problems than it solves. Any one of these new machines in our home would have an issue and start the same series of events: hours on hold with a medical supplier call center, waiting for our hospice provider to call us back, and furious googling: all to no avail. In a time where my Dad and my family desperately needed time with each other, we spent time dealing with technology we didn’t understand. This example is one of many from my own experience, and I’ve learned it’s a common refrain across end of life care. The current state of technology in end of life care, and across all of healthcare, is that the technology is available, but far from accessible and not human-first.
Building human-first technology isn’t a new concept. In 2001 we gained agile software development, centered around rapid user feedback, and it’s now ubiquitous in all of software culture. In the 1970s, design thinking came about and had an immense influence on early software development and computer science foundations. Even 2.6 million years ago, we were using stone tools that fit our hands incredibly well. Despite our track record as a species, the US healthcare industry struggles with building and maintaining human-first technology.
The Problem
The biggest example is our industry-wide obsession with improved outcomes and lower care costs. There’s no doubt that improving patient and population health outcomes while lowering the cost of care is a good thing. Not to mention, it’s an overarching standard that aligns insurers, government agencies, and digital health startups. The problem is that an outcomes-driven approach reduces the complexity and humanity of each patient. It doesn’t handle less structured and less targeted health information well. Digital health tools ignore or struggle to make use of a patient’s co-morbidities, their loved ones’ emotional and behavioral states, their environmental stressors, their life goals and lifestyle, their identity, and a million other factors that fall outside their primary diagnosis. The structured approach of digital health products — and the structured data sets and systems digital health products are built on — leave out the greater, personalized picture of each patient as a human being.
Outcomes-driven digital health tools also ignore the surrounding factors of a patient’s health. Health apps dependent on the internet (most of them) and are inaccessible to the 20% of US households without internet access[1]. Even with a connection, we know that patients face barriers from wildly varying levels of digital literacy, unwillingness to use new technology, cultural norms, and lack of trust in technology and healthcare alike. Telemedicine, although just one facet of digital health, is a prime example of innovation without access. We saw a national pandemic roll-out of telehealth to every corner of healthcare. Now: telehealth accounts for less than 5% of all commercial insurance claims[2]. Healthcare technology has made huge strides, but digital health tools are far ahead of their own accessibility and usefulness.
The Solution
Human-first technology in healthcare requires a new approach. We need to measure outcomes without forgetting about our patients as human beings. Engineers, designers, and technology folks need to break out of the digital-only paradigm. Digital health products, and the startups building them, need to embrace a human-first approach to their technology. Just like a single provider treating a single patient, we need to account for the unexpected, the unstructured, and the intrinsically messy picture of a person’s life. If healthcare is inherently human, digital health must be too.
My experience taking care of my Dad kick-started my journey in digital health. I became driven to take everything I learned building startups and digital tools across different industries and apply it to healthcare innovation. That very journey brought me to Guaranteed Health — a mission-driven, human-first digital health startup.
At Guaranteed, we’re building a tech-enabled hybrid at-home end of life care model from the ground up. We have a big vision for the impact our technology will have on end of life care, but we know that we must constrain our product roadmap within the human-first approach of our care providers. This is human-first digital health. When we ideate, design, and build our technology, we follow these guidelines:
- 🤝 Integration-First: We start from the technology and interfaces a patient, their family, and their providers use already. From there, we ask what we can build that seamlessly integrates into their daily life? How might we create ubiquitous technology? How might we build tools that live in the background? How might we build for interoperability from the start?
- 👵 Digitally-Supported, not Digital-First Care: Our care delivery model is centered around patient and family experience. Any tools we build must live in the context of the human-centric care we provide. How might our tools enhance the important patient, caregiver, and provider interactions happening already?
- 📈 Scale Human-First: Digital health products scale quickly and massively. It’s our job to build products that underscore human interaction, human emotion, and personalization. Then when our products scale, so do the immensely positive ripple effects of human connection.
We’re committed to shifting the health and human paradigms in end of life care. We’re excited to bring technology and innovation to an area of healthcare in desperate need of attention and resources. We’re glad to be bringing along providers, payers, and investors on our mission. And above all, we’re empowered to be a digital health company that builds products centered around the human experience.
About Guaranteed Health
Guaranteed is a care company that is changing the way we die. We’re a digital health startup providing hybrid at-home end of life care. We’re also looking for talented product and engineering folks to join the mission and rebuild end of life care with us.
Sources
- “Switched Off: Why Are One in Five U.S. Households Not Online?” National Telecommunications and Information Administration, 2022, https://ntia.gov/blog/2022/switched-why-are-one-five-us-households-not-online.
- FAIR Health, Inc. “Monthly Telehealth Regional Tracker | FAIR Health.” Healthcare Data Solutions for a New Generation | FAIR Health, FAIR Health, 2022, https://www.fairhealth.org/states-by-the-numbers/telehealth.
